Don’t let azoospermia turn your life upside down
Azoospermia is a medical condition, where there is complete absence of sperms in the semen.After the first test, It is not a pleasant task to inform my patient that, we did not find any sperm in your semen sample .To confirm azoospermia, semen testing should be repeated at least 3 times with a gap of one month between each test, because sometimes test may show no sperms, due to some injury, illness or reproductive tract infection even in men with normal sperm count .
There are array of blood tests and investigations which will give sufficient information to confirm whether the condition is treatable or not .
Few years back, I had a patient working in Middle East who had low hormones (panhypopituatarism) and azoospermia, .He trusted me so much that he was ready to take hormone injections for six months and wait for the results.So the injections were ice packed and given to be taken to gulf.After few months, I was extremely happy, when the couple came to meet me with positive pregnancy test, when he came home on a one month leave .When I see the birthday photos of the child every year, it gives me so much of contentedness, satisfaction and lot of positive energy to continue my practice .
Although I have done lot of successful ICSI for cases with TESA for azoospermia with obstruction, I advice my patients to opt for donor sperm treatment in cases of failure .Instead of repeated ICSI failures, I want to see the couple have a healthy baby and save their finances.After all ICSI is expensive and emotionally taxing for both patients and the the treating doctor.
Generally, I have observed in my practice that, most of the men take the news calmly and maturely.We may think that they will feel inadequate and depressed , but i have found the other way round, many of them feel very confident and not reluctant to opt for donor sperm .Seeing their concern for their better half, I feel happy for the wives.So much of understanding and love is never seen in a couple when everything is perfect.Most of them are more than willing to have their wives undergo donor insemination , (in case of untreatable azoospermia as in testicular failure cases) , so that the wife is happy and contended to have a baby.In some patients, the low levels of testosterone may be a reason for their less aggressive nature and flexibility and caring nature.It often makes me wonder if illness and troubles is nature’s way to keep you grounded on your feet and not get carried away ..
Compared to women who do not have healthy eggs of their own going for an egg donor , I find azoospermic men are more acceptable to the idea of a donor gamete.Acceptance in the sense of not just agreeing for donor gamete , but to accept the child as his own.Proper counseling does play an effective role in the decision.
I find some men , who are conservative , wanting to have donor embryo , so,that their wives eggs are not mixed with a donor sperm.The best option for these couple would have been adoption, but i understand their reluctance is because of the social pressure and opposition from own family members and society .
I wish our society was as broad minded as western countries when it comes to adoption.
Dr.Anita Mani
Infertility& Surrogacy Specialist at Gift IVF Centre
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